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RESEARCH PRODUCT
Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients
Francisco ArteagaJose M PorresRosa Porro-fernándezJoaquín Fernández De La ConchaVíctor PalancaIgnasi AngueraB Quesada-oceteFernando De La Guía-galipiensoAurelio QuesadaJuan Gabriel MartinezJavier Alzueta-rodriguezJavier Quesada-oceteLuisa Pérez-álvarezFabian Sanchis-gomarFabian Sanchis-gomarXavier ViñolasJosé Martínez-ferrerJavier JimenezRafael Romero-villafrancasubject
Malemedicine.medical_specialtyVentricular Tachyarrhythmiasmedicine.medical_treatmentPopulationCardiac resynchronization therapycardiac resynchronization therapyheart failureDisease030204 cardiovascular system & hematologyVentricular Function LeftCardiac Resynchronization Therapy03 medical and health sciences0302 clinical medicineInternal medicinemedicineHumanssex030212 general & internal medicinecardiovascular diseaseseducationRetrospective StudiesHeart Failureeducation.field_of_studyLeft bundle branch blockbusiness.industryIncidence (epidemiology)Arrhythmias CardiacStroke VolumeRetrospective cohort studyventricular tachyarrhythmiamedicine.diseasemortalityTreatment OutcomeHeart failureCardiologycardiovascular systemFemalebusinessdescription
OBJECTIVES The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients. BACKGROUND Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited. METHODS A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up through remote monitoring after the first implantation of a CRT-D during a median follow-up of 2.2 +/- 1.0 years. Sex differences were analyzed in terms of ventricular arrhythmia-treated incidence and death during the follow-up period, with a particular focus on primary prevention patients. RESULTS Baseline New York Heart Association functional class was worse in women compared with that in men (67.0% of women in New York Heart Association functional class III vs. 49.7% of men; p = 0.003), whereas women had less ischemic cardiac disease (20.8% vs. 41.7%; p < 0.001). Female sex was an independent predictor of ventricular arrhythmias (hazard ratio: 0.40; 95% confidence interval: 0.19 to 0.86; p = 0.020), as well as left ventricular ejection fraction and nonischemic cardiomyopathy. Mortality in women was one-half that of men, although events were scarce and without significant differences (2.9% vs. 5.6%; p = 0.25). CONCLUSIONS Women with left bundle branch block and implanted CRT have a lower rate of ventricular tachyarrhythmias than men. All-cause mortality in patients is, at least, similar between female and male subjects. (C) 2021 by the American College of Cardiology Foundation.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 |